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Individual

MILO LJOSENVOOR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
120 N HIGHWAY 53, COOK, MN 55723-8100
(218) 666-5325
(218) 666-2307
Mailing address
PO BOX 32, BIGFORK, MN 56628-0032

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
122468
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
122468
MINNESOTA PHARMACIST LICENSE
MN
01
14920
NEBRASKA PHARMACIST LICENSE
NE
01
20755-40
WISCONSIN PHARMACIST LICENSE
WI
Enumeration date
04/29/2019
Last updated
04/15/2026
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